Jamie Dupree’s Washington Insider

While most Americans were more focused on family gatherings, turkey dinners, football and Black Friday shopping trips, Republicans in the Congress quietly unveiled a massive health policy initiative over the Thanksgiving break – what seems to be a legislative Christmas tree on health policy – that lawmakers hope to speed through the House and Senate before wrapping up work for the year.

Known as the “21st Century Cures Act,” the $6.3 billion plan is designed to spur new medical innovation and research by the federal government – but at almost 1,000 pages of legislative text – it’s also rapidly become a magnet for action on other varied health-related issues in the Congress.

While Republicans have been promising action on this plan for the last few weeks, the details of the 996 page measure were not made public until after 5 pm on Thanksgiving Friday – a vote has been set for the plan on Wednesday in the House.

One legislative note – the provisions of this measure will be attached to a separate bill that deals with tsunami warnings.

Among the many highlights in this new medical plan:

+ The main goal of the bill is fostering new health innovation and research at the National Institutes of Health and the Food and Drug Administration.

+ NIH would get $4.8 billion extra over 10 years new efforts at cancer research, brain research, precision medicine and more.

+ The FDA would get $500 million over 10 years to expedite approval of new drugs and medical devices, while not sacrificing safety.

+ The bill also includes $1 billion in new grants over two years to help states deal with opioid abuse.

+ Also added to the plan were new legislative reforms for the nation’s health care system, including $14 million in grants to help change how services are provided by states

+ $12.5 million in grants would be made available to help states better maintain a database of available treatment facilities for those facing mental health issues

+ Another $10 million would be used to help attract medical residents and others to practice psychiatry and follow career paths in other mental health professions

My 1st thoughts on today's draft of 21st Century Cures: some bad provisions are gone, some remain, & some to watch. https://t.co/u6A2fI7yUu

Just reading through all of the programs, the grants, and the sheer volume of different issues, it’s obvious that this plan has been the subject of very heavy lobbying – and has all sorts of different provisions dealing with health and more.

Sec. 9031. Mental health and substance use disorder services on campus.
Sec. 9032. Interagency Working Group on College Mental Health.
Sec. 9033. Improving mental health on college campuses.
TITLE X—STRENGTHENING MENTAL AND SUBSTANCE USE DISORDER CARE FOR CHILDREN AND ADOLESCENTS

Sec. 19021. Elimination of time limit for family reunification services while in foster care and permitting time-limited family reunification services when a child returns home from foster care.
Sec. 19022. Reducing bureaucracy and unnecessary delays when placing children in homes across State lines.
Sec. 19023. Enhancements to grants to improve well-being of families affected by substance abuse.
Subtitle C—Miscellaneous

Sec. 19031. Reviewing and improving licensing standards for placement in a relative foster family home.
Sec. 19032. Development of a statewide plan to prevent child abuse and neglect fatalities.
Sec. 19033. Modernizing the title and purpose of title IV–E.
Sec. 19034. Effective dates.
TITLE XX—ENSURING THE NECESSITY OF A PLACEMENT THAT IS NOT IN A FOSTER FAMILY HOME

Sec. 20001. Limitation on Federal financial participation for placements that are not in foster family homes.
Sec. 20002. Assessment and documentation of the need for placement in a qualified residential treatment program.
Sec. 20003. Protocols to prevent inappropriate diagnoses.
Sec. 20004. Additional data and reports regarding children placed in a setting that is not a foster family home.
Sec. 20005. Effective dates; application to waivers.
TITLE XXI—CONTINUING SUPPORT FOR CHILD AND FAMILY SERVICES

Sec. 21001. Supporting and retaining foster families for children.
Sec. 21002. Extension of child and family services programs.
Sec. 21003. Improvements to the John H. Chafee foster care independence program and related provisions.
TITLE XXII—CONTINUING INCENTIVES TO STATES TO PROMOTE ADOPTION AND LEGAL GUARDIANSHIP

Sec. 23001. Technical corrections to data exchange standards to improve program coordination.
Sec. 23002. Technical corrections to State requirement to address the developmental needs of young children.
TITLE XXIV—ENSURING STATES REINVEST SAVINGS RESULTING FROM INCREASE IN ADOPTION ASSISTANCE

Sec. 24001. Delay of adoption assistance phase-in.
Sec. 24002. GAO study and report on State reinvestment of savings resulting from increase in adoption assistance.
TITLE XXV—SOCIAL IMPACT PARTNERSHIPS TO PAY FOR RESULTS

Sec. 25001. Short title.
Sec. 25002. Social Impact Partnerships to Pay for Results.
Sec. 25003. Extension of TANF program.
Sec. 25004. Strengthening welfare research and evaluation and development of a What Works Clearinghouse.
Sec. 25005. Technical corrections to data exchange standards to improve program coordination.

What’s obvious from all of that? This plan has clearly been the subject of a lobbying blitz.